Objectives
High levels of dental care‐related fear/anxiety, as well as phobia, result in delay or avoidance of dental care, which are associated with poorer oral and overall health. Both pharmacotherapeutic and psychosocial methods are available to treat those with high levels of dental fear/anxiety or phobia, but they are infrequently used and not easily accessed. Smartphones are a potential vehicle for delivering exposure therapy (e.g., a treatment involving systematic encounter with fear‐evoking stimuli), but there is a need to test the acceptability of this approach in regard to treatment of high levels of dental anxiety/fear and phobia.
Methods
There were 36 patients with high dental anxiety/fear/phobia randomly assigned to either a treatment or a waitlist condition. Participants completed a pre‐ and two‐week post‐multimodal assessment, including a dental behavioral avoidance task. The treatment condition included 2 weeks of self‐directed exposure delivered via a personal smartphone in the patients' natural environment.
Results
Participants in the treatment condition utilized the smartphone exposure an average of 1.6 times daily (SD = 0.85), and found the self‐directed exposure highly acceptable. Moreover, they had lower self‐reported anxiety and decreased cardiac reactivity at the postassessment compared with the preassessment; no change in anxiety was found for the control condition from pre‐ to postassessment.
Conclusions
Highly anxious, fearful, and dental phobic participants utilized smartphone‐delivered exposure therapy, and found it to be an acceptable treatment method. Results support the utility and promise for further testing of the personal smartphone in delivering self‐directed exposure therapy for high dental fear/anxiety and phobia.
Background
The experience of pain is a complex interaction of somatic, behavioural, affective and cognitive components. Negative psychological states (e.g., anxiety, fear and depression) are intertwined with pain and contribute to poorer outcomes for individuals suffering from chronic and acute pain by exacerbating the overall experience of pain and leading to increased dysfunction, disability, and distress. A need exists for efficient assessment of aversive emotional states that are associated with pain.
Methods
A multistage developmental process included expert judges, two undergraduate samples, and a chronic pain patient sample. The 4‐item Brief Assessment of Distress about Pain (BADP) scale was developed to assess anxiety, fear, and depression related to pain, as well as an overall evaluation of distress about pain.
Results
Principal components analyses indicated that the BADP consisted of one factor. Inter‐scale correlation coefficients revealed that the BADP was highly related to other measures that assess similar constructs, suggesting evidence for convergent validity. Intra‐scale correlation coefficients indicated that the items of the BADP were only moderately associated with each other. Findings also supported evidence for discriminative validity, test–retest reliability, and internal consistency of the BADP.
Conclusions
The BADP has good psychometric properties as a measure of negative affectivity related to pain. The scale's single negative affectivity item may be useful for screening. The BADP helps address a gap in the literature with regard to a brief measure assessing fear, anxiety, depression, and negative affect in relation to pain. Demonstrated utility in a patient sample indicates the measure is suitable for further clinical study.
Significance
The BADP provides an efficient, psychometrically‐supported means to assess affective distress (i.e., anxiety, fear, depression, and negative affect) associated with pain.
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